Wednesday, October 26, 2005

Hart tries to explain the unexplainable

Hart hosts Medicare insurance forum

By Tamara Simpson
Tuesday, October 25, 2005

Jack Maurer has attended two information sessions about the government's new Medicare prescription coverage -- including one Monday in Harrison, but he's still not sure if he'll opt in.

"I don't know if this is worthwhile or not, but it's insurance," the Harrison resident said. "Insurance is there in case something happens."

Maurer already has prescription coverage as a retiree from Allegheny Ludlum, but he's still considering the Medicare plans because they might be cheaper.

But with all the new plans, there's a lot more to consider than price.

"There will be several different plans that are offered through Medicare, and you are certainly free to not choose any," said U.S. Rep. Melissa Hart, R-Bradford Woods, who offered the information session Monday morning at Citizens Hose in Harrison. "These are all voluntary, and that's a really good thing because if the plan you have now is a great plan, and it doesn't cost you too much money, I'd encourage you to keep it.

"But if the plan you have now is a little more expensive than you like, or if the plan you have now is not covering some of the prescriptions you want to take, then maybe you can find a better plan through Medicare."

Anne Logoyda, a social worker from Landmark Home Health Care, was at the session to present the basics of Medicare's new program to a roomful of senior citizens.

As of Nov. 15, eligible residents will be able to enroll in a Medicare prescription drug plan. The plans are offered by insurance companies and other private companies, but they are all Medicare-approved.

Some things to consider when trying to decide on a plan are premiums, deductibles, prescription co-payments, the plan's formulary -- what drugs it covers -- and what pharmacies you can go to.

Hart said anyone who doesn't have any prescription coverage should be sure to take advantage of Medicare's new plan.

But what about someone like Maurer, who already has coverage?

The first thing Maurer intends to do is find out if his current plan compares favorably to Medicare's plan.

If it is, that means he can choose to continue with that plan. If that plan is discontinued at any time in the future, which he thinks it will be, then Maurer can switch to a Medicare plan with no penalty.

A penalty does apply, however, to any eligible residents who enroll after the May 15, 2006, deadline. The penalty is 1 percent of the plan's premium for each month after the deadline.

For example, if someone decides to enroll in a Medicare plan with a $30 premium five months after the May 15 deadline, then that person will have to pay an additional $15 per month. Their monthly premium would be $45 instead of $30.

Logoyda said that's why it's important for people to sit down with their families and officials to make a decision before the deadline.

Another thing to consider is eligibility for a subsidy or decrease in cost, Logoyda said.

Subsidies are available for people with an annual income less than $14,355 and assets that total no more than $11,500.

For married couples living together, the income limit is $19,245 and less than $23,000 in assets.

A person's house and car are not included as assets.

Logoyda said anyone meeting these requirements must apply for the subsidy and will not necessarily get a full subsidy.

"There's so much to this program, and it's so confusing," said Madeline Napoli from Gilpin, who attended the session with her husband, Bob. "I don't want to make the wrong decision. Who knows what's going to happen down the road as far as illnesses?"Just what seniors need, a plan that no one seems to be able to explain or understand. It's way past time for single payer healthcare in this country.
From Physicians for a National Health Care Program:
Physicians for a National Health Program is a not-for-profit organization of physicians, medical students, and other health care professionals that support a national health insurance (NHI) program. Specifically, we believe that a single-payer system (where the government finances health care, but keeps the delivery of health care to mostly private control) is the only solution to solving the United States' many health care problems: 43 million citizens with no health insurance, many more with only limited coverage, skyrocketing health insurance premiums, malpractice costs, long-term care issues, and relatively poor health indicators, when compared to similar industrialized nations.


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